血流导向装置治疗未破裂颅内动脉瘤的长期疗效：系统评价和荟萃分析。
Long-term outcomes of flow diversion for unruptured intracranial aneurysms: a systematic review and meta-analysis.
机构信息
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
J Neurointerv Surg. 2023 Sep;15(9):898-902. doi: 10.1136/jnis-2022-019240. Epub 2022 Sep 23.
BACKGROUND
Flow diverters have been widely used in clinical practice for more than a decade. However, most outcome data are limited to 1 year timepoints. This study aims to offer meta-analysis data on long-term (>1 year) safety and effectiveness results for patients with aneurysms treated with flow diverters.
METHODS
PubMed, Web of Science, Embase, and SCOPUS were searched up to February 24, 2022 using the AutoLit platform. We included primary studies assessing the long-term outcomes for flow diverter devices to manage unruptured internal carotid artery aneurysms with a follow-up period of >1 year. The meta-analysis was carried out using Comprehensive Meta-Analysis software (CMA).
RESULTS
Eleven studies were included in the meta-analysis. The pooled occlusion rates after flow diversion treatment for unruptured intracranial brain aneurysms were 77%, 87.4%, 84.5%, 89.4%, 96% for 1 year, 1-2 years, 2 years, 3 years, and 5 years follow-up, respectively. The in-stent stenosis rate was 4.8% and the retreatment rate for the long-term follow-up period was 5%. No delayed rupture of the aneurysm was reported, and there was one case of delayed ischemic stroke. The sensitivity analysis of the prospective studies showed a complete occlusion rate of 83.5% and 85.2% for 1 and 3 years of follow-up, respectively.
CONCLUSION
Flow diverters are safe and effective in short- and long-term follow-up and rarely cause serious delayed side effects.
背景
血流导向装置在临床实践中已经应用了十余年。然而，大多数结果数据仅限于 1 年时间点。本研究旨在提供关于使用血流导向装置治疗动脉瘤患者的长期（>1 年）安全性和有效性结果的荟萃分析数据。
方法
使用 AutoLit 平台在 PubMed、Web of Science、Embase 和 SCOPUS 上检索截至 2022 年 2 月 24 日的文献。我们纳入了评估血流导向装置长期结果的原始研究，以治疗未破裂颈内动脉动脉瘤，随访时间>1 年。使用 Comprehensive Meta-Analysis 软件（CMA）进行荟萃分析。
结果
11 项研究纳入荟萃分析。血流分流治疗未破裂颅内脑动脉瘤的闭塞率分别为 77%、87.4%、84.5%、89.4%、96%，随访 1 年、1-2 年、2 年、3 年和 5 年。支架内狭窄率为 4.8%，长期随访期间的再治疗率为 5%。未报告动脉瘤延迟破裂，有 1 例迟发性缺血性卒中。前瞻性研究的敏感性分析显示，1 年和 3 年随访的完全闭塞率分别为 83.5%和 85.2%。
结论
血流导向装置在短期和长期随访中安全有效，很少引起严重的迟发性副作用。
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